Depressive symptom clusters are differentially associated with general and visceral obesity

To examine the relationship between obesity and depressive symptoms taking into account different measures for obesity (body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR)) and different depressive symptom clusters.

Cross-sectional population-based survey.

Baseline data of the Nijmegen Biomedical Study.

One thousand two hundred eighty-four persons aged 50 to 70.

Obesity (BMI, WC, and WHR) and depressive symptoms were measured, the latter using the Beck Depression Inventory (BDI). Principal components analysis of the BDI items yielded two factors, one representing a cognitive-affective symptom cluster and the other a somatic-affective symptom cluster. Multiple regression analyses corrected for confounders were conducted for each measure of obesity, with separate models testing the BDI sum score and the depression symptom clusters.

BMI was significantly associated with BDI sum score (β=0.12, P<.001) and the cognitive- (β=0.08, P=.008) and somatic-affective symptom clusters (β=0.10, P=.001). WC (β=0.11, P<.001) and WHR (β=0.07, P=.004) were specifically associated with the somatic-affective symptom cluster.

Visceral obesity, which is more indicative of vascular risk than BMI, is specifically associated with somatic-affective depressive symptom cluster, which might suggest that these symptoms are primarily due to a (subclinical) somatic condition.